Retired Physician and Physician Assistant Membership Application

We are looking forward to your membership with the OMA! Please fill out the secure application below.

CONTACT INFORMATION
PROFESSIONAL INFORMATION
PERSONAL INFORMATION
PROFESSIONAL AFFILIATIONS
AGREEMENT

I hereby apply for membership in the Oregon Medical Association and agree to abide by its bylaws and policies and the Principles of Medical Ethics of the Oregon Medical Association. If my medical license is issued by a state other than Oregon, I agree to notify the OMA of any changes to my licensure status. I authorize the OMA and its affiliates to communicate member benefit information by e-mail and facsimile.

OTHER

If you have any questions, call OMA at (503) 619-8000 or send an e-mail to oma@theOMA.org.

v2 2016